To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The catastrophic declines of three species of ‘Critically Endangered’ Gyps vultures in South Asia were caused by unintentional poisoning by the non-steroidal anti-inflammatory drug (NSAID) diclofenac. Despite a ban on its veterinary use in 2006 (India, Nepal, Pakistan) and 2010 (Bangladesh), residues of diclofenac have continued to be found in cattle carcasses and in dead wild vultures. Another NSAID, meloxicam, has been shown to be safe to vultures. From 2012 to 2018, we undertook covert surveys of pharmacies in India, Nepal and Bangladesh to investigate the availability and prevalence of NSAIDs for the treatment of livestock. The purpose of the study was to establish whether diclofenac continued to be sold for veterinary use, whether the availability of meloxicam had increased and to determine which other veterinary NSAIDs were available. The availability of diclofenac declined in all three countries, virtually disappearing from pharmacies in Nepal and Bangladesh, highlighting the advances made in these two countries to reduce this threat to vultures. In India, diclofenac still accounted for 10–46% of all NSAIDs offered for sale for livestock treatment in 2017, suggesting weak enforcement of existing regulations and a continued high risk to vultures. Availability of meloxicam increased in all countries and was the most common veterinary NSAID in Nepal (89.9% in 2017). Although the most widely available NSAID in India in 2017, meloxicam accounted for only 32% of products offered for sale. In Bangladesh, meloxicam was less commonly available than the vulture-toxic NSAID ketoprofen (28% and 66%, respectively, in 2018), despite the partial government ban on ketoprofen in 2016. Eleven different NSAIDs were recorded, several of which are known or suspected to be toxic to vultures. Conservation priorities should include awareness raising, stricter implementation of current bans, bans on other vulture-toxic veterinary NSAIDs, especially aceclofenac and nimesulide, and safety-testing of other NSAIDs on Gyps vultures to identify safe and toxic drugs.
This chapter has two objectives. First, I define and describe the spatial and temporal variation in international capital and authoritarian politics. The former comprises the book’s key independent variable, while the latter is the book’s main dependent variable. Second, I illustrate the existence of an association between international capital and political survival in autocracies in the raw data. Such an examination is useful as it illustrates the book’s central empirical prediction without having to “finesse” the data to establish a statistical relationship between international capital and authoritarian politics. These associations provide motivation for further theoretical and empirical inquiry. To be clear, I do not claim a causal relationship between international capital and authoritarian politics in this chapter. Causal evaluations are the focus of Chapters 4 to 6.
Throughout history a strong executive with limited constraints on his or her political authority has been a prerequisite for dictatorship. Of course, the ability of autocrats to enjoy these low constraints on their rule requires sufficient revenues to repress and buy loyalty via patronage.
This chapter presents cross-national evidence that remittances can finance authoritarian politics, by lowering the constraints dictators face and extending their time in power. Endogeneity, however, plagues efforts to test whether a causal relationship exists between remittance income and authoritarian politics. To overcome this empirical challenge, I leverage a quasi-natural experiment of oil price–driven remittance flows emanating from the Persian Gulf to non–oil-producing Muslim countries in North Africa, the Middle East, and South Asia.
For many dictators, their longevity and legitimacy depend on their ability to financially support regime supporters and deliver broad-based economic growth, for when this financial capital and growth disappears (or their prospects), so do most of the reasons for allies to remain loyal. For countries determined to industrialize, such as those in Latin America and East and Southeast Asia, attracting sufficient foreign capital has been instrumental in economic development and legitimizing the state’s authoritarian rule.
This chapter presents cross-national evidence that foreign direct investment (FDI), particularly in high fixed cost industries (e.g., oil exploration, petrochemicals), can create rents that an autocrat can use to fund the military. In doing so, these governments are able to retain the loyalty of a key domestic ally. Moreover, for many countries attracting foreign capital is part of a broader strategy of fostering economic growth.
The trends in Chapter 2 provide preliminary evidence of a positive association between international capital inflows and leader survival in less democratic polities. But why should inflows of foreign aid, remittances, and foreign direct investment (FDI) affect the fate of leaders, and do so more in nondemocratic regimes? After all, these capital inflows are received by various actors within an economy and do not all necessarily accrue directly to governments. This chapter develops a theory that explains how governments can use capital inflows to fund strategies of political survival. In particular, international capital can embody nontax properties that enable leaders to finance repression and accumulate loyalty.
A central argument in Chapter 3 is the proposition that autocrats can use nontax income to finance a combination of repression and patronage as a means of extending their tenure in office. While various scholars have investigated the relationship between foreign aid and patronage, there is surprisingly less scholarship evaluating the impact of aid on repression. With this in mind, this chapter presents robust evidence that foreign aid from the world’s largest bilateral – the United States – can harm political rights, expand the powers of dictators, and entrench nondemocratic institutions in recipient states. As this chapter describes in greater detail, one such example is General Siad Barre’s use of US aid to finance his repressive dictatorial rule.
Cross-border flows of foreign aid, foreign direct investment (FDI), and remittances are salient features of the global economy. These transfers involve different actors – firms, governments, and households – in almost every country. For many countries, these capital flows account for a significant share of national income that can potentially affect politics. This raises an important question: can governments harness these foreign capital flows to their political advantage? And if this is the case, how might governments do so? These are the central questions addressed by this book.
Attracting financial capital is essential for economic growth in developing countries, but tragically can often foster nondemocratic politics. Consider, for example, the impact of foreign aid. Since 2008 Ethiopia has been one of the largest recipients of US aid in Africa, averaging around $80 million per year. While the aid is intended to foster economic development, practitioners are growing increasingly wary of its political ramifications. Before the Ethiopian national election in 2010, foreign donors were charged with “subsidizing a regime that is rapidly becoming one of the most repressive and dictatorial on the continent.” Western aid officials “seem reluctant to admit that there are two Prime Minister Meles Zenawis. One is a clubbable, charming African who gives moving speeches at Davos and other elite forums about fighting poverty and terrorism. The other is a dictator whose totalitarianism dates backs to Cold War days.”
Can foreign capital empower dictatorship? This groundbreaking book develops a unified theory that links three prominent forms of international capital to the endurance of dictatorships. International capital empowers governments to finance two key instruments of non-democratic politics: repression and patronage. The Perils of International Capital uses theory, case studies, and cross-national statistical evidence to demonstrate causal effects between foreign capital and authoritarian politics. These finding are crucial to scholars and policymakers alike, as they call for a recalibration of the welfare effects associated with greater financial globalization. Ahmed reveals that, while foreign capital may improve economic development, it can tragically hinder democratic governance in the process.
Background: Previous studies have shown varied results with respect to the diagnostic utility of a positive nerve root sedimentation sign (SedSign) on MRI for symptomatic lumbar stenosis. The objective of this study was to analyze the clinical characteristics of SedSign utilizing a validated classification for low back and leg pain (Saskatchewan Spine Pathway classification; SSPc). Methods: This was a retrospective review of prospectively-collected data in 367 consecutive adult patients presenting to a spine surgeon with back and/or leg pain between January 1, 2012 and May 31, 2018. Inter- and intra-rater reliability for SedSign was 73% and 91%, respectively (3 examiners). Results: SedSign was positive in 111 (30.2%) and negative in 256 (69.8%) of patients. On the univariate analysis, a positive SedSign was correlated with age, male sex, several components of ODI, EQ5D mobility, cross-sectional area (CSA) of stenosis, and SSPc pattern 4 (intermitted leg dominant pain). On multivariate analysis, SedSign was associated with age, male sex, CSA stenosis and ODI sub-score for walking distance. The sensitivity and specificity of SedSign for neurogenic claudication was 50.3 and 82.9, respectively (positive predictive value 65.8%, negative predictive value 71.9%). Conclusions: The SedSign has high specificity for neurogenic claudication, but the sensitivity is poor.
Background: The nerve root sedimentation sign (SedSign) has been correlated with clinically significant lumbar spinal stenosis (LSS), and promoted as a possible prognostic indicator. However, diagnostic methods were not clearly defined in prior reports. In this study, the clinically validated Saskatchewan Spine Pathway enabled diagnosis of neurogenic claudication due to LSS. The objective was to compare the outcome of lumbar laminectomy for neurogenic claudication with respect to SedSign. Methods: This was a retrospective analysis of prospectively-collected data in patients with neurogenic claudication who underwent lumbar laminectomy. Outcome measures included Oswestry Disability Index, Visual Analogue Scale (VAS) for back and leg pain, and EuroQol 5-Dimension questionnaire. Results: Laminectomy was performed in 106 patients, and 60 were SedSign positive. Outcomes did not differ with respect to SedSign for all outcome measures, in non-instrumented and instrumented cohorts. Improvement in walking distance was associated with dural cross-sectional area of stenosis (p=0.02). VAS back and leg improvements were associated with back dominant (p=0.038) and leg dominant (p=0.0036) pain. Conclusions: This is the largest analysis of SedSign with respect to operative outcomes, and the only study with validated criteria for defining neurogenic claudication. Although other radiological and clinical factors are associated with improvements, SedSign did not correlate with laminectomy outcome.
Background: While recent clinical trials have demonstrated immense efficacy of mechanical thrombectomy (MT) in the setting of acute stroke, there remains debate over the safety in performing this procedure under general anesthesia (GA). In the Saskatchewan Acute Stroke Pathway, all patients presenting with LVO have endovascular thrombectomy performed under GA. Methods: Data was retrospectively reviewed on 108 consecutive LVO in 2016-2017. All MT were done under GA. Anatomical location of LVO, pre-MT ASPECTS score, post-MT TICI scores and 90-day NIHSS and mRS were recorded. Results: Of 108 LVO, 103 went on to have MT. 44 were right anterior circulation, 50 were left anterior circulation and 9 were posterior circulation. Of 94 anterior circulation strokes, 47 (50.0%), 43 (45.7%) and 4 (4.3%) had good, moderate and poor collateral circulation respectively, and the average pre-MT ASPECTS was 8.6. The average pre-MT NIHSS was 14.7. 81/90 (90.0%) achieved thrombolysis in cerebral infarction (TICI) perfusion scale grade of 2b/3 after recanalization. Average documented 90-day NIHSS was 2.4 and mRS was 2.5. Overall mortality was 21/103 (20.4%). Conclusions: In the Saskatchewan acute stroke pathway, general anesthesia is a safe modality for MT. This adds to the body of evidence supporting GA as a viable option for sedation in MT.